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https://www.readbyqxmd.com/read/29453922/a-short-review-of-primary-aldosteronism-in-a-question-and-answer-fashion
#1
Frederick-Anthony Farrugia, Nicolaos Zavras, Georgios Martikos, Panagiotis Tzanetis, Anestis Charalampopoulos, Evangelos P Misiakos, Dimitrios Sotiropoulos, Nikolaos Koliakos
OBJECTIVES: The aim of this study was to present up to date information concerning the diagnosis and treatment of primary aldosteronism (PA). PA is the most common cause of endocrine hypertension. It has been reported up to 24% of selective referred hypertensive patients. METHODS: We did a search in Pub-Med and Google Scholar using the terms: PA, hyperaldosteronism, idiopathic adrenal hyperplasia, diagnosis of PA, mineralocorticoid receptor antagonists, adrenalectomy, and surgery...
January 1, 2018: Endocrine Regulations
https://www.readbyqxmd.com/read/29422627/the-influence-of-the-peripheral-cortisol-fluctuation-on-the-success-rate-of-adrenal-venous-sampling
#2
Chin-Chen Chang, Bo-Ching Lee, Kao-Lang Liu, Yeun-Chung Chang, Vin-Cent Wu, Kuo-How Huang, Tung-Hsin Wu
In this retrospective study, we aimed to estimate the influence of fluctuating peripheral plasma cortisol concentration (PCC) on the success rate of non-stimulated adrenal venous sampling (AVS) and to demonstrate its fluctuating pattern. Overall, 107 consecutive patients with primary aldosteronism undergoing AVS between July 2015-January 2017 were included. The peripheral vein was sampled at 4 separate time points during the procedure: after femoral puncture, during left adrenal sampling, during right adrenal sampling, and before procedural ending...
February 8, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29409357/macrolides-for-kcnj5-mutated-aldosterone-producing-adenoma-mapa-design-of-a-study-for-personalized-diagnosis-of-primary-aldosteronism
#3
Giuseppe Maiolino, Giulio Ceolotto, Michele Battistel, Giulio Barbiero, Maurizio Cesari, Laurence Amar, Brasilina Caroccia, Roberto Padrini, Michel Azizi, Gian Paolo Rossi
PURPOSE: Aldosterone-producing adenoma (APA) is the main curable cause of endocrine hypertension cause of primary aldosteronism (PA) and it is in up to 66% of all cases investigated with adrenal vein sampling (AVS). Mutations in the KCNJ5 potassium channel involve up to 70% of APA and cause the most florid PA phenotypes. The recent finding that macrolide antibiotics specifically inhibit in vitro the altered function of mutated KCNJ5 channels has opened new horizons for the diagnosis and treatment of APA with KCNJ5 mutations in that it can allow identification and target treatment of PA patients harbouring a mutated APA...
February 6, 2018: Blood Pressure
https://www.readbyqxmd.com/read/29388434/annals-express-improved-technical-success-and-radiation-safety-of-adrenal-vein-sampling-using-rapid-semi-quantitative-point-of-care-cortisol-measurement
#4
Michael M Page, Mario Taranto, Duncan Ramsay, Greg van Schie, Paul Glendenning, Melissa Gillett, Samuel Vasikaran
OBJECTIVE: Primary aldosteronism is a curable cause of hypertension which can be treated surgically or medically depending on the findings of adrenal vein sampling (AVS) studies. AVS studies are technically demanding with a high failure rate in many centres. The use of intra-procedural cortisol measurement could improve the success rates of AVS but may be impracticable due to cost and effects on procedural duration. DESIGN: Retrospective review of the results of AVS procedures since commencement of point of care cortisol measurement using a novel single-use semi-quantitative measuring device for cortisol, the AVS Accuracy Kit (AAK)...
January 1, 2018: Annals of Clinical Biochemistry
https://www.readbyqxmd.com/read/29378066/technical-note-free-and-bound-cortisol-in-plasma-and-saliva-during-acth-challenge-in-dairy-cows-and-horses
#5
A-C Schwinn, F Sauer, V Gerber, R M Bruckmaier, J J Gross
Cortisol levels reflect hypothalamic-pituitary-adrenocortical (HPA) axis activity. While most plasma cortisol is supposed to be bound to the soluble cortisol binding globulin (CBG), only free cortisol (FC) actively regulates metabolic and immunological processes. We aimed to establish a multi-species suitable method to assess FC in cows and horses which in combination with total cortisol (TC) allows interpreting proportional changes of cortisol in saliva as well as in blood in response to a standardized HPA axis activation via ACTH...
January 25, 2018: Journal of Animal Science
https://www.readbyqxmd.com/read/29366348/case-report-an-identical-twin-with-sertoli-leydig-cell-tumor
#6
Kristy Cho, Jon C Havelock, Blake Gilks, Caitlin Dunne
Our report details the workup and management of a 43-year-old woman with an identical twin who presented with 2 years of virilization and secondary amenorrhea. Serum total testosterone was elevated. An MRI did not identify adnexal or adrenal pathology. Subsequent ovarian vein sampling demonstrated unilateral testosterone elevation. The patient underwent laparoscopic unilateral oophorectomy resulting in the diagnosis of Sertoli-Leydig cell tumor (SLCT). Although SLCT is a rare sex-cord ovarian tumor, it is associated with endometrial hyperplasia and malignancy...
January 24, 2018: Gynecological Endocrinology
https://www.readbyqxmd.com/read/29357735/niche-point-of-care-endocrine-testing-reviews-of-intraoperative-parathyroid-hormone-and-cortisol-monitoring
#7
Li-Sheng Chen, Ravinder J Singh
Point-of-care (POC) testing, which provides quick test results in near-patient settings with easy-to-use devices, has grown continually in recent decades. Among near-patient and on-site tests, rapid intraoperative and intra-procedural assays are used to quickly deliver critical information and thereby improve patient outcomes. Rapid intraoperative parathyroid hormone (ioPTH) monitoring measures postoperative reduction of parathyroid hormone (PTH) to predict surgical outcome in patients with primary hyperparathyroidism, and therefore contributes to the change of parathyroidectomy to a minimally invasive procedure...
January 22, 2018: Critical Reviews in Clinical Laboratory Sciences
https://www.readbyqxmd.com/read/29238437/persistent-primary-aldosteronism-despite-iatrogenic-adrenal-hemorrhage-after-adrenal-vein-sampling
#8
Keisuke Okamura, Tetsu Okuda, Kazuyuki Shirai, Ichiro Abe, Kunihisa Kobayashi, Tatsu Ishii, Seiji Haraoka, Hidenori Urata
Before surgery for primary aldosteronism (PA), localization is evaluated with adrenal vein sampling (AVS). A 56-year-old Japanese woman had a right adrenal mass, hypokalemia, and a high aldosterone/renin ratio. Stress tests confirmed the diagnosis of PA. Subsequently, preoperative AVS was performed and right adrenal hemorrhage (AH) occurred unexpectedly. Because hypertension persisted, laparoscopic right adrenalectomy was performed. Postoperatively, the blood pressure was normalized. Pathological examination revealed an adrenal cortical adenoma largely unaffected by necrosis and hemorrhage...
January 2018: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/29229748/adrenal-vein-sampling-is-the-preferred-method-to-select-patients-with-primary-aldosteronism-for-adrenalectomy-con-side-of-the-argument
#9
Jaap Deinum, Aleksander Prejbisz, Jacques W M Lenders, Gert Jan van der Wilt
No abstract text is available yet for this article.
January 2018: Hypertension
https://www.readbyqxmd.com/read/29229742/adrenal-vein-sampling-is-the-preferred-method-to-select-patients-with-primary-aldosteronism-for-adrenalectomy-pro-side-of-the-argument
#10
Gian Paolo Rossi, John W Funder
No abstract text is available yet for this article.
January 2018: Hypertension
https://www.readbyqxmd.com/read/29198769/subtyping-of-primary-aldosteronism-with-adrenal-vein-sampling-hormone-and-side-specific-effects-of-cosyntropin-and-metoclopramide
#11
Giacomo Rossitto, Giuseppe Maiolino, Livia Lenzini, Valeria Bisogni, Teresa Maria Seccia, Maurizio Cesari, Maurizio Iacobone, Gian Paolo Rossi
BACKGROUND: Cosyntropin and metoclopramide can affect the subtyping of primary aldosteronism when used with adrenal vein sampling by exerting hormone- and side-specific effects on cortisol and aldosterone secretion. We investigated how these stimuli affect the selectivity index, the relative aldosterone secretion index, and the lateralization index in consecutive primary aldosteronism patients submitted to adrenal vein sampling. METHODS: We recruited 171 patients; of these, 149 underwent adrenal vein sampling before and after stimulation with cosyntropin (250 µg intravenous bolus, n= 53, 73% with an aldosterone-producing adenoma) or with metoclopramide (10 mg intravenous bolus, n= 96, 65% aldosterone-producing adenoma), and 32 with an aldosterone-producing adenoma were investigated for the relative gene expression of dopamine, melanocortin 2, and 5-hydroxytryptamine (serotonin) 4 receptor with microarrays...
November 30, 2017: Surgery
https://www.readbyqxmd.com/read/29176594/subtype-prediction-of-primary-aldosteronism-by-combining-aldosterone-concentrations-in-the-left-adrenal-vein-and-inferior-vena-cava-a-multicenter-collaborative-study-on-adrenal-venous-sampling
#12
Yuichi Fujii, Hironobu Umakoshi, Norio Wada, Takamasa Ichijo, Kohei Kamemura, Yuichi Matsuda, Tatsuya Kai, Tomikazu Fukuoka, Ryuichi Sakamoto, Atsushi Ogo, Tomoko Suzuki, Kazutaka Nanba, Mika Tsuiki, Mitsuhide Naruse
Subtype diagnosis of primary aldosteronism (PA) by adrenal vein sampling (AVS) is recommended as a mandatory step for indicating adrenal surgery. It is a technically demanding procedure, especially in the right adrenal vein. The aim of the study was to predict the subtype diagnosis in the absence of values from the right AVS. From the databases of nine centers (WAVES-J), 308 patients with PA who underwent successful AVS were studied. Based on the ipsilateral ratio (IR) (aldosterone/cortisol ratio of the left adrenal vein [A/Cleft AV] / aldosterone/cortisol ratio of the inferior vena cava [A/CIVC]), the patients were divided into two groups: the patients with IR ≥ 1...
November 24, 2017: Journal of Human Hypertension
https://www.readbyqxmd.com/read/29174432/primary-aldosteronism-making-sense-of-partial-data-sets-from-failed-adrenal-venous-sampling-suppression-of-adrenal-aldosterone-production-can-be-used-in-clinical-decision-making
#13
Veljko Strajina, Zahraa Al-Hilli, James C Andrews, Irina Bancos, Geoffrey B Thompson, David R Farley, Melanie L Lyden, Benzon M Dy, William F Young, Travis J McKenzie
BACKGROUND: It has been suggested that accurate clinical decisions may be made in patients with primary aldosteronism (PA) in the setting of failed cannulation of an adrenal vein, thereby utilizing only data from either right or left adrenal venous sampling (AVS) alone. METHODS: Retrospective analysis was performed for all patients with PA who underwent successful bilateral AVS. Adrenal vein/inferior vena cava index (AV/IVC index) was calculated by dividing aldosterone/cortisol ratio of the adrenal vein by aldosterone/cortisol ratio in the inferior vena cava, as described in a previously published study...
November 22, 2017: Surgery
https://www.readbyqxmd.com/read/29165736/the-spartacus-trial-controversies-and-unresolved-issues
#14
Felix Beuschlein, Paolo Mulatero, Evelyn Asbach, Silvia Monticone, Cristiana Catena, Leonardo A Sechi, Michael Stowasser
Adrenal vein sampling (AVS) is considered the gold standard for the differential diagnosis in patients with primary aldosteronism (PA). The distinction between unilateral and bilateral disease dictates the targeted therapeutic approach with surgery for aldosterone producing adenomas and medical therapy for patients with bilateral hyperplasia. Thereby, this diagnostic step is crucial in clinical care. As AVS is an invasive, not well standardized procedure that is restricted to few specialized centers, several attempts have been made to simplify diagnostic algorithms...
December 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/29161416/combined-ovarian-and-adrenal-venous-sampling-in-the-localization-of-acth-independent-ectopic-cushing-s-syndrome
#15
Shi Chen, Ran Li, Xiaobo Zhang, Lin Lu, Ji Li, Hui Pan, Huijuan Zhu
Context: Cushing's syndrome is rarely caused by the secretion of cortisol from the ovarian tumors. It is important to determine whether the ovarian tumor is capable of secreting cortisol or not in clinical decision making. Selective ovarian and adrenal venous sampling has not been reported previously in the localization of ACTH-independent ectopic Cushing's syndrome. Case description: Herein, we presented a case of 40-year-old Chinese woman who has been manifested with weight gain, hirsutism, hypertension and menstrual disorder over a period of 6 months...
November 16, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29141372/-role-of-adrenal-vein-sampling-in-differential-diagnosis-of-primary-aldosteronism-subtypes
#16
H Y Li, P Li, S M Shen, X B Zhang, W H Feng, H Huang, W Chen, D L Zhu
Objective: To investigate the role of adrenal vein sampling (AVS) in identifying the subtype of primary aldosteronism (PA). Methods: AVS was performed in 50 patients who were confirmed as PA between September 2010 and September 2016 in Nanjing Drum Tower Hospital. Clinical, biochemical and follow-up data were reviewed retrospectively. Bilaterally simultaneous catheterization without cosyntropin stimulation and contemporaneous cortisol measurement during AVS were used. Selectivity index (SI)≥1.5 suggested that the sample was from the adrenal vein...
November 14, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29129366/contralateral-suppression-of-aldosterone-at-adrenal-venous-sampling-predicts-hyperkalemia-following-adrenalectomy-for-primary-aldosteronism
#17
Omair A Shariq, Irina Bancos, Patricia A Cronin, David R Farley, Melanie L Richards, Geoffrey B Thompson, William F Young, Travis J McKenzie
BACKGROUND: We aimed to determine whether a greater degree of contralateral suppression of aldosterone secretion at adrenal venous sampling predicted the development of postoperative hyperkalemia after unilateral adrenalectomy for primary aldosteronism. METHODS: A retrospective analysis of patients undergoing unilateral adrenalectomy for primary aldosteronism between 2004-2015 was performed. Clinical and biochemical parameters of patients who developed hyperkalemia (≥5...
November 9, 2017: Surgery
https://www.readbyqxmd.com/read/29126147/adrenocorticotropin-acutely-regulates-pregnenolone-sulfate-production-by-the-human-adrenal-in-vivo-and-in-vitro
#18
Juilee Rege, Aya T Nanba, Richard J Auchus, Jianwei Ren, Hwei-Ming Peng, William E Rainey, Adina F Turcu
Background: Dehydroepiandrosterone sulfate (DHEAS) is the most abundant steroid in human circulation, and ACTH is considered the major regulator of its synthesis. Pregnenolone sulfate (PregS) and 5-Androstenediol-3-sulfate (AdiolS) have recently emerged as biomarkers of adrenal disorders. Objective: To define the relative human adrenal production of ∆5-steroid sulfates under basal and cosyntropin-stimulated conditions. Methods: Liquid chromatography-tandem mass spectrometry was used to quantify three unconjugated and four sulfated ∆5-steroids in: 1) paired adrenal vein (AV) and mixed venous serum samples (21 patients), and 2) cultured human adrenal cells, both before and after cosyntropin stimulation; 3) microdissected zona fasciculata (ZF) and zona reticularis (ZR) from 5 human adrenal glands; 4) reconstituted in vitro human 17α-hydroxylase/17,20-lyase (CYP17A1/ P450 17A1) system...
November 6, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29124355/a-multi-institutional-comparison-of-adrenal-venous-sampling-in-patients-with-primary-aldosteronism-caution-advised-if-successful-bilateral-adrenal-vein-sampling-is-not-achieved
#19
Tracy S Wang, Greg Kline, Tina W Yen, Ziyan Yin, Ying Liu, William Rilling, Benny So, James W Findling, Douglas B Evans, Janice L Pasieka
INTRODUCTION: In patients with primary aldosteronism (PA), adrenal venous sampling (AVS) is recommended to differentiate between unilateral (UNI) or bilateral (BIL) adrenal disease. A recent study suggested that lateralization could be predicted, based on the ratio of aldosterone/cortisol levels (A/C) between the left adrenal vein (LAV) and inferior vena cava (IVC), with a 100% positive predictive value (PPV). This study aimed to validate those findings utilizing a larger, multi-institutional cohort...
November 9, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29103467/visualization-of-right-adrenal-vein-comparison-with-three-phase-dynamic-contrast-enhanced-ct
#20
Yoshifumi Noda, Satoshi Goshima, Shoma Nagata, Hiroshi Kawada, Nobuyuki Kawai, Hiromi Koyasu, Masayuki Matsuo
PURPOSE: To evaluate the visualization of the right adrenal vein (RAV) on dynamic contrast-enhanced computed tomography (CT) images in patients with primary aldosteronism. MATERIALS AND METHODS: We evaluated 27 consecutive patients with primary aldosteronism who underwent contrast-enhanced dynamic CT and subsequent adrenal venous sampling. Scan delays were 10-, 20- and 60-s after a bolus-tracking program detected that the threshold of a 100 Hounsfield units (HU) increase in the abdominal aorta had been achieved...
November 2017: European Journal of Radiology
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